Sunday, July 21, 2013

If You Thought Australian E-Health Governance Was Working You Are Presently Wrong.

Two meetings happened last week which confirm the unresponsive mess we are in.
First we had a meeting involving DoHA, NEHTA, The Pharmacy Guild, the AMA, the TGA the MSIA and others.
They were meeting to try and sort out the now expanding mess that was mentioned in this blog found here:
Well, what essentially happened was that, despite it becoming clear the risks were even larger than initially thought and that more prescribed medicines than initially understood were involved, essentially no agreed plan to change the way monthly updates were provided to software vendors and thus their users were made to make the system consistent and safe. Indeed frustration that the problem had become public was expressed by some bureaucrats.
So we have more and more risks of wrong dispensing resulting from poor updates of the medication information from the PBS as vendors find themselves between their customers and the Government.
DoHA, NEHTA and the TGA should have come to the meeting with a well-considered plan as to how the issue - which everyone agrees exits - is to be fixed and quickly. Nope, no such outcome.
Second we had a wonderful example of nonsense at a recent teleconference where Standards Australia (SA) was discussing with members of the IT-14 (Health Informatics Committee) the support that would be provided for Australian Experts to travel to conferences representing us at the major Standards meetings. What was desired from the members was transparency as to the principles that were applied to the selection of who should attend.
SA proceeded to make it clear that principles existed, that they were secret and would not be changing! Talk about a rock and a hard place.
Catch 22 I reckon.
See here:
and here:
for some exciting background.
One can only hope that the Deloitte’s refresh of the 2008 National E-Health Strategy can sort the leadership and governance issues around the present situation asap and that the Government will actually listen and make the needed changes.
David.

4 comments:

Anonymous said...

Dream on David, Dream on!

Hope springs eternal but unfortunately hope will not resolve the intractable mess Australia's eHealth Governance structures and operations are in.

Why would the 2013 version of an expensive Deloitte document make the slightest bit of difference where the 2008 version failed to reform the dysfunctional and unaccountable Australian eHealth Governance regime?

Let's not forget, 2014 will be the "10th Anniversary" of the 2004 BCG document that delivered Australia our beloved NEHTA organization!

Ten years and how many Millions/Billion of direct cost/waste and "Opportunity Cost", and for what exactly?

Dream, dream, dream, dream, dream :||

Anonymous said...

Perhaps this is the beginning of the inference 7/20/2013 05:42:00 PM was riddling? Or just coincidence?

Anonymous said...

Why would the 2013 version of an expensive Deloitte document make the slightest bit of difference ...

Good question.

It all depends on why Deloitte has been asked to deliver another document.

Options are:
1. To justify a reorg and chivvy the CEO out the door.
or
2. To justify moving NEHTA back in house under Medicare's management.
or
3. To prove that 'some' progress has been made in line with Deloitte's earlier recommendations.
or
4. To prepare for closing NeHTA down, calling a tender to take on the next stage of ehealth development and transferring NEHTA's work to date to the successful tenderer. In effect outsourcing NEHTA through acquisition to either a private sector entity or Medicare.
5. Another option?

Anonymous said...

5. Another option?

Perhaps it's an attempt to reinforce the credibility of Deloitte's original strategy which recommended that eScripts should be the highest ehealth priority.

Government is very disappointed that the uptake of eScripts has not been as rapid as originally expected even though the script exchange vendors and the doctors have doctors done everything expected of them. The pharmacists have not.

Instead of changing their work practices many pharmacists have resisted bar coding by continuing to manually typing every single prescription into their computer system. This banal act of stupidity is he last remaining impediment to the widespread uptake of ehealth in primary care. In essence, the pharmacists are blocking progress,

Perhaps the Deloitte document will recommend mandating scanning of eScripts as a precondition for paying pharmacists for dispensing prescriptions.

It's a very simple way to encourage change. The PSA and the Guild are supportive.